Agenda item

Briefing Note of the Director of Adult Services

The Health and Social Care Scrutiny Board (5) received a Briefing Note and presentation by the Head of Adult Social Care and Support in response to the Boards concerns regarding the increasing demand for Adult Social Care and the potential impact of this on assessment or review response times.

Adult Social Care had a series of assessment duties under the following legislation:

• Care Act 2014
• Mental Health Act 1983
• Mental Capacity Act 2005
• Disabled Facilities Grant (DFG)

Referrals to social care could be made from a number of sources including the person themselves, family or friends or a GP.  The majority of referrals were received via the online referral form and dependent on the source of referral and the team responsible for responding, different processes were applied to assess risk and prioritise.

Adult Social Care had seen an increase in safeguarding referrals and more complex situations, most of which were deemed high risk and high priority and therefore required a more urgent response.

All referrals were screened by intake teams within Adult Social Care to prioritise based on risk and to determine next steps.  There were three levels of prioritisation based on need, priority, status and chronology and these were urgent, medium and standard.

Overall levels of risk were monitored by Heads of Service with resourcing decisions made as appropriate to manage risk levels within the service.  Escalation processes were in place to ensure cases were appropriately risk assessed and allocated accordingly.

Within Coventry, there were approximately 3500 people in receipt of ongoing care and support with an average of 200 referrals per week into social work teams.  The Care Act statutory guidance stated that it was an expectation that authorities should conduct a planned review of the support in place on an annual basis.  Currently, 55% of people with a support package would have been reviewed within the prescribed time frame.

The hospital social work team also received a high level of referrals with on average, 700 referrals per month.  All referrals to the Hospital Social Work team were allocated on the same day.  The Deprivation of Liberty safeguards (DOLs), was seeing a year on year increase for new assessment and renewal requests.  Demand on this service was so high that there was a waiting period for assessment.

There were currently 191 cases waiting for the DFG (Disabled Facility Grant) to be completed.  In addition, there were 342 DFG’s in the process of completion either by Coventry City Council or the Housing Association.  Reasons for this ranged from issues with property ownership, agreeing specifications and availability of contractors or service users choice as to when the work could be completed.  Officers were working closely with Housing and Housing Association colleagues and an improvement plan was in place to reduce the wait times.

The increasing demand on Adult Social Care in terms of complexity of casework and legal standing had meant waiting times were longer for some.  This would be a likely area of challenge in the forthcoming CQC Inspections.

Members of the Scrutiny Board, having considered the content of the Briefing Note and presentation, asked questions and received information from officers on the following matters:

• How cases were prioritised according to status and risk and response times to urgent/standard and lower risk cases.
• Finding a way to manage urgent assessments alongside lengthy wait times including the recruitment of additional staff.
• Acting in the service users’ best interests when capacity had diminished.
• How the increase in requests of a safeguarding nature of 50% were being processed.
• Waiting times versus case complexity
• More complex needs due to the impact of the pandemic and later referrals to service
• Absence of case number national benchmarking data
• Response times according to the urgency of the case and to disagreements between the service user and their family whether an assessment was required.
• Response times to assessments under the Mental Health Act
• Data collection and caseload feedback, audits and speaking with service users
• Regular reporting on data to improve services
• Importance of feedback from service users and how this shaped service delivery
• Workforce management, pressures and caseloads

RESOLVED that the Scrutiny Board notes the work of Adult Social Care and understands the approaches and mechanisms that are in place to manage demand on Adult Social Care Services.